02/04/1998
I
I
I
l~_~
Dr. Dennis L. Jackson, Chairman, called the regular business meeting of the New Hanover
County Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, February 4, 1998, in
the Dr. Thomas Fanning Wood Library, New Hanover County Health Department, Wilmington,
North Carolina.
Members Present:
Dennis L. Jackson, DVM, Chairman
William T. Steuer, PE/RLS, Vice-Chairman
Thomas V. Clancy, MD
Henry V. Estep
Michael E. Goins, OD
Robert G. Greer, County Commissioner
Gela N. Hunter, Nurse Practitioner
Wilson O'Kelly Jewell, DDS
W. Edwin Link, Jr., RPH
Anne Braswell Rowe
Estelle G. Whitted, RN
Members Absent:
Others Present:
David E. Rice, Health Director
Lynda F. Smith, Assistant Health Director
Frances F. De Vane, Recording Secretary
Invocation: Mrs. Anne Rowe gave the invocation.
Minutes:
Dr. Jackson called for corrections to the minutes of the January 7, 1998 Board of Health
Meeting. The minutes of the meeting of January 7, 1998 were approved by the New Hanover
County Board of Health.
Recognitions:
Mr. Rice introduced and welcomed new health department employees and recognized recipients
of Service Awards given by the New Hanover County Commissioners.
New Employees
Virginia L. Clegg, Public Health Nurse - Communicable Disease
Sheila M. Foery, Licensed Practical Nurse II - Child Health
Rhonda S. Howell, Animal Control Officer - Animal Control Services
Monica E. Roberson, Health Educator I - Project ASSIST
Service Awards
Five (5) Years
Daisy S. Brown, Administrative Assistant I - Administration
Hazel L. Hewitt, Clerical Assistant - Administration
114
Fifteen (15) Years
Susan T. Barfield, Public Health Nurse II - Community Health
Margaret R. Horton, Public Health Nurse II - Child Health
Twenty (20) Years
Cynthia S. Johnson, Public Health Nurse II - Communicable Disease
On behalf of the Board of Health, Dr. Jackson welcomed the new employees and expressed his
appreciation to the New Hanover County Service Award recipients.
I
Department Focal:
SEAL THE STATE IN '98
Dr. David McDaniel, Dental Health Director, gave the departmental focal on "SEAL THE
STATE IN '98," a coalition of public and private community volunteers working to provide
98,000 dental sealants for children in every county in North Carolina. He introduced Dr.
William K. Atkinson, President, CEO, and Ms. Sharon Benoit, Marketing Strategist, New
Hanover Regional Medical Center. Local "SEAL THE STATE IN '98" sponsors are the Cape
Fear Community College Dental Assisting Program, New Hanover Regional Medical Center,
Wilmington Tri-County Dental Society, and the New Hanover County Health Department.
Dr. McDaniel advised the purpose of "SEAL THE STATE IN '98" is to prevent dental decay
through the increased use of dental sealants and to educate the public regarding the benefits of I
dental sealants both locally and statewide. The target date for applying the sealants is the week
of February 2-6. The goal of the local dental sealant promotion initiative is to provide 1,000
free dental sealants to New Hanover County children. Eighty-one local dentists volunteered to
provide 810 dental sealants. Also, the Cape Fear Community College Dental Assisting Program
is to provide free dental sealants to school children.
Dr. Jackson thanked Dr. McDaniel for his presentation on "SEAL THE STATE IN '98." Dr.
Jewell reiterated dental sealants are beneficial and dental sealants decrease dental decay by 80%.
Committee Reports:
Executive Committee
Dr. Jackson, Chairman, Executive Committee, reported the Executive Committee met at 6:00
p.m. on Thursday, January 22, and at 6:00 p.m. on Monday, February 2, 1998.
Budget Amendment Process - Temporary Assistance to Needy Families Grant - $28.374
Dr. Jackson recommended from the Executive Committee for the Board of Health to approve
the budget amendment process.
Mr. Rice explained this is a request for a guideline regarding advising the Board of Health of
budget amendments for additional monies of more than $10,000 from the state that the grants I
have been approved. He explained in his past experience as Health Director in Reno, Nevada, a
budget amendment more than $10,000 was submitted to the Board of Health for approval.
L -'- '>'
I
Dr. Jackson gave an example in which Ms. Betty Jo McCorkle, Women's Health Director,
received an additional $28,374 grant allocation from the state for Temporary Assistance to
Needy Families to reduce the number of out of wedlock births through education, pregnancy
tests, etc. The allocation is from the Women's Preventive Health Branch of the North Caroli a
Department of Health and Human Services and is to provide temporary salary, advertisin , ,~g
supplies for T ANF.
Mr. Rice reiterated he feels uncomfortable with the Board of Health not being aware of re eip
of additional or new monies from federal, state, and private sectors; even though, the g ts
have been approved.
I
MOTJION: Dr. Jackson moved from the Executive Committee for the Board of Health to se a
guideline for any additional budget amendment for additional monies in the amount of $10,0 0
or more (without personnel positions) shall be presented to the Executive Committee for
recommendation for submission to the Board of Health for their consideration. If there is
grant deadline related to the budget amendment, the Executive Committee may be notified b
phone of the additional monies. lUpon vote, the M01'][ON D][D N01' CARRY.
-L Voting Aye
-º- Voting Nay
Dr. Clancy proposed for the full Board of Health to approve budget amendments for additional
monies in the amount of $10,000 or more and for the Board to participate in this decision
making process. Mr. Steuer, Mr. Link, and Mr. Greer concurred the entire Board of Health
should be aware of and should approve the additional monies for more than $10,000. Dr.
Jackson stated if there are time constraints relating to a budget amendment, the full Board could
be polled by telephone. Mr. Greer stated any budget amendment with personnel positions is
submitted to the County Commissioners.
SUJßS1'][1'U1'JE M01'][ON: Ms. Rowe MOVED, SECONDED by Mr. Steuer for the Board of
Health to approve any budget amendment of additional monies in the amount of $10,000 or
more (unless new personnel requested) shall be presented to the Executive Committee for
recommendation and for submission to the Board of Health for their consideration. If there is a
grant deadline relating to the budget amendment, the Board of Health members shall be polled
by phone of the additional monies. lUpon vote, the M01'][ON CARRKJEJI) lUNAN][MOlUSJL Y.
Mr. Estep inquired about the acceptance of the $28,374 grant allocation from the state for the
Temporary Assistance to Needy Families (TANF).
Ms. McCorkle explained the $28,374 TANF grant allocation was appropriated by the North
Carolina General Assembly to decrease the number of births out of wedlock. The Women's
Health staff plans to work with the Department of Social Services in this project.
M01'ION: Dr. Jackson moved from the Executive Committee for the Board of Health to
accept and approve the Temporary Assistance to Needy Families Grant allocation ($28,374)
from the Women's Preventive Health Branch of the North Carolina Department of Health and
Human Services to reduce the number of out of wedlock births. lUpon vote, the M01'][ON
CARRKJED UNAN][MOlUSJL Y.
I
Strategic JPHannñng - OrganizationaH Capacity Assessment
Dr. Jackson informed the Board Mr. Rice presented an Organizational Capacity Assessment
Plan to the Executive Committee on February 2, 1998. The Executive Committee approved this
strategic planning process and the Committee recommends to the Board the acceptance and
116
approval of the implementation of this project.
Mr. Rice reported on Tuesday the Management Team endorsed the implementation of the
strategic plan. He gave a presentation to the Board of Health on the Organizational Capacity
Assessment Plan (Assessment Protocol for Excellence in Public Health - APEX/PH). He
reviewed the steps of the following of the three parts:
I. Organizational Capacity Assessment - 8 Steps
1. Preparation
2. Score Indicators for Importance and Current Status
3. Identify Strengths and Opportunities to Improve
4. Analyze and Report Strengths
5. Analyze Opportunities to Improve
6. Rank Problems in Order of Priority
7. Develop and Implement Action Plan
8. Institutionalize the Assessment Process
Areas of Indicators - 9 Areas
1. Indicators for Authority to Operate
2. Indicators for Community Relations
3. Indicators for Community Assessment
4. Indicators for Public Policy Development
5. Indicators for Assurance of Public Health Services
6 Indicators for Financial Management
7. Indicators for Personnel Management
8. Indicators for Program Management
9. Indicators for Policy Board Procedures
II. The Community Process
1. 1998 Community Diagnosis
III. Completing the Cycle
1. Assess
2. Plan
3. Implement
4. Evaluate
Mr. Rice advised this is a team effort which requires time and commitment. It includes
participation of the Management Team and Staff, Board of Health, and County Commissioners.
He expressed the process is to establish a base line to move forward, to improve the way we do
business at the Health Department, and to improve communication between staff, other
agencies, and the public. The process should be evaluated and repeated every two years.
The Board concurred a strategic plan is needed for the health department which includes
assessment and the evaluation of services.
I
I
MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to I
accept and to approve the implementation of the Organizational Capacity Assessment Plan as
presented by Mr. Rice. Upon vote, the MOTION CARRIED UNANIMOUSLY.
I
.f ~ 7
Health Promotions Committee
Dr. Goins, Chairman, Health Promotions Committee, reported the Health Promotions
Committee met at 5:30 p.m. on Wednesday, January 28, 1998. He advised on January 13, 1998,
Mr. Rice and Mr. Andy Atkinson, Deputy County Manager, met with Mr. Alfred Thomas, Chief
Executive Officer, at the New Hanover Community Health Center (NHCHC) to address
concerns relating to indigent patient access to primary health care at the facility. After the
meeting in a memo to Mr. Rice, Mr. Thomas outlined the indigent patient access to health
services at the NHCHC. This document from Mr. Thomas stated NHCHC is not a free clinic,
but it does see patients regardless of their ability pay. Dr. Goins stated the 1998 Community
Diagnosis addresses concerns regarding availability of medical services to the indigent
population. He advised the Health Promotions Committee and Mrs. Betty Creech, Community
Health Director, are to continue to monitor the availability of primary health services to
indigent patients.
Dr. Goins announced the Fourth Annual Commit to Quit Contest sponsored by Project ASSIST
begins February 1 - March 16, 1998. Participants must be 18 years of age and remain smoke-
free for this six-week period. A celebration party for smoke-free participants is to be held at the
on March 16 at the Coast Line Convention Center.
Dr. Goins announced the Health Promotions Committee is to judge the Rabies - Protect Your
Pet, Protect Yourself Animal Control Services Poster Contest opened to Grades 4, 5, and 6.
Local winning posters are to be displayed at the Public Health Month Health Fair to be on
April 18, 1998, at Independence Mall and then entered in the Environmental Health Section of
North Carolina Public Health Association Contest.
I Budget Committee
Ms. Anne Rowe, Chairman, Budget Committee, reported Board members have reviewed each
program budget.
Ms. Smith, Assistant Health Director, reported the total 1998-99 Budget Request is $7,844,874
which is an increase of $396, 545 from the FY 1997-98 Amended Budget. Revenues have
increased by $236,500. The projected net increased cost to the county is $160,045. The budget
request does not include a salary market adjustment or merit.
I
Ms. Smith presented overheads which showed summary pages 1-9 of the Budget Workbooks.
She explained budget requests for 6 new positions, capital requests, revenues earned by the
health department, and the county appropriations.
A discussion of the budget requests for new positions, operating expenses, and projected
revenues followed. Mr. Steuer reiterated a larger 20 ft. boat is needed by Vector Control. Ms.
Dianne Harvell, Environmental Health Director, investigated the capacity and safety of the boat
in the budget request and she reported the capital outlay request needs to be ipcreased by $6,000
for the boat larger boat.
Ms. Rowe advised the Executive Committee approved the 1998-99 Budget Request with the
exception of waiting for Ms. Harvell's investigation regarding the need and cost of a larger,
safer boat for the Vector Control Program of the Environmental Health Division.
Ms. Rowe thanked the Budget Committee and Ms. Smith for their assistance with the
preparation of the budget request.
118
MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
approve the FY 1998-99 New Hanover County Health Department Budget Request as presented I
including a $6,000 increase in the capital outlay request to purchase a larger, safer boat for the
Mosquito Control Program in Vector Control. Upon vote, the MOTION CARRIED
UNANIMOUSLY.
Unfinished Business:
New Business:
New Hanover County Board of Health Bylaws
Dr. Jackson recommended from the Executive Committee the acceptance of the New Hanover
County Board of Health Bylaws.
Dr. Goins requested the Board to review the section of the Board of Health Bylaws relating to
the election of officers. He explained the proposed bylaws state in November the floor is
opened for nominations for the Board of Health officers. He reiterated the importance of
nominees agreeing to serve as a candidate for an officer of the Board of Health prior to their
nomination. Dr. Jackson concurred nominees must give their permission prior to their
nomination.
MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
approve the New Hanover County Board of Health Bylaws. Upon vote, the MOTION I
CARRIED UNANIMOUSLY.
A copy of the New Hanov~r County Board of Health Bylaws (Attachment #1) is hereby
incorporated as a part of the minutes.
Rabies Control and Animal Licensing
Dr. Jackson postponed the Rabies Control and Animal Licensing agenda item to a later date. He
explained the Rabies Control and Animal Licensing process is being addressed.
Animal Control Services (ACS) Advisory Committee Terms of Office
Dr. Jackson recommended from the Executive Committee for the Board of Health to approve
appointments of Animal Control Services Advisory Committee members to begin serving
staggering terms of office in January 1999 and to place a limitation on the members' terms of
office to two consecutive terms with the exception if a category cannot find a replacement
member to serve on the ACS Advisory Committee.
Mr. Rice explained ACS Advisory Committee members are appointed by the Board of Health to
serve three-year terms beginning in January and ending in December 31. Staggering terms
would prevent the situation of several of the Committee members rotating off at the same time.
Also, currently there is no limit on the number of terms a member may serve on the Advisory
Committee.
I
I
I
I
"11 q
MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
approve appointments of Animal Control Services Advisory Committee members to begin
serving staggering terms of office in January 1999 and to place a limitation on the members'
terms of office to two consecutive terms with the exception if a category cannot find a
replacement member to serve on the ACS Advisory Committee. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
Comments:
Board Members
Dr. Jackson expressed his appreciation to the Board of Health Committee Chairmen for their
committee reports presented to the Board.
Health Director
1998 Annual Meeting of State and Local Health Directors
Mr. Rice reported Ms. Lynda Smith, Trish Jones, Student Intern, and he attended the Annual
State and Local Health Directors' Meeting held on January 15-16, 1998, in Raleigh. The
keynote address was "Public Health Partnerships in the New Millennium." A workshop
followed on "Strategic Communication: How to Make the Most of Crises/Opportunities With
the Media." Updates were presented on other public health issues, and Dr. Ronald H. Levine,
Deputy Secretary, North Carolina Department of Health and Human Services, gave the closing
remarks.
Employee Appreciation Luncheon
Mr. Rice stated the Board of Health is hosting an Employee Appreciation Luncheon between
the hours of 12:00 p.m. - 1 :30 p.m. on Thursday, April 9, 1998. Dr. Goins stated Board
members are to prepare the hamburgers and six to eight cooks are needed. The cooks should
arrive at the Health Department by 11 :30 a.m.
Health Director's Monthly Report. December
Mr. Rice announced the December 1997 Health Director's Monthly Report has been mailed to
the Board.
Pictorial Display
Ms. Smith reminded Board members to have their pictures taken immediately following the
Board meeting for the pictorial display to be placed at the health department entrance. Mr. Joe
Johnson, Coastal Area Health Education Center (AHEC), is available at AHEC to take the
pictures of the Board and the Management Team.
120
Other Business:
Association of North Carolina Boards of Health
Mr. Rice reported he is arranging with Mr. Carmine Rocco, Executive Director, Association of
North Carolina Boards of Health, for a local training session for Boards of Health members.
Adjourn:
There being no further business, the regular business meeting of the Board of Health was
adjourned at 9:25 a. m.
Approved:
I
I
I
1_ 2"'1
Attachment I
I
BYLAWS
OF THE NEW HANOVER COUNTY BOARD OF HEALTH
ARTICLE I
Name
The name of this organization shall be the New Hanover County Board of Health,
hereinafter referred to as "Board of Health."
ARTICLE II
Object
The object of the Board of Health shall be set forth under Chapter 130A of the North
Carolina General Statutes and the New Hanover County Code.
Section 1. The Board of Health shall be the policy-making, rule-making and
adjudicatory body for the New Hanover County Health Department.
Section 2. The Board of Health shall have the responsibility to protect and promote
the public health. The Board of Health shall have the authority to adopt rules necessary for
that purpose.
I
Section 3. The Board of Health may adopt a more stringent rule in an area regulated
by the Commission for Health Services or the Environmental Management Commission
where, in the opinion of the Board of Health, a more stringent rule is required to protect the
public health; otherwise the rules of the Commission for Health Services or the rules of the
Environmental Management Commission shall prevail over the Board of Health rules.
Section 4. The rules of the Board of Health apply to all incorporated and unincorporated
areas of New Hanover County.
Section 5. Except for codes and standards adopted by reference, all rules and regulations
adopted, amended or altered by the Board of Health must meet certain procedural
requirements in order to have the force and effect of law.
Section 6. The Board of Health may, in its rules, adopt by reference any code, standard,
rule or regulation which has been adopted by any agency of North Carolina, another state,
any agency of the United States or by a generally recognized association.
I
Section 7. The Board of Health may impose a fee for services to be rendered by the New
Hanover County Health Department, except where the imposition of a fee is prohibited by
statute, or where an employee of the Health Department is performing the services as an
agent of the State.
Adopted, February 4, 1998
122
ARTICLE III
Members
The members of the Board of Health shall be set forth under Chapter 130A of the North
Carolina General Statutes.
I
Section 1. The New Hanover County Board of Commissioners shall appoint the
members of the Board of Health. The Board of Health shall be composed of 11 members.
The composition of the Board of Health shall reasonably reflect the population makeup of
New Hanover County and shall include: one physician licensed to practice medicine in North
Carolina, one licensed dentist, one licensed optometrist, one licensed veterinarian, one
registered nurse, one licensed pharmacist, one county commissioner, one professional
engineer, and three representatives of the general public. All members shall be residents of
New Hanover County.
Section 2. Members of the Board of Health shall serve three-year terms. Except for the
county commissioner, no member shall be eligible to serve for more than two consecutive
terms. Vacancies shall be filled for any unexpired portion of a term.
Section 3. Members of the Board of Health may receive a per diem in an amount
established by the New Hanover Board of Commissioners. Reimbursement for subsistence
and travel shall be in accordance with a policy set by the Board of Commissioners.
Section 4. No member should vote on a question in which he/she has a direct personal
or pecuniary interest not common to other members of the Board of Health.
I
ARTICLE IV
Officers
Section 1. The officers of the Board of Health shall be a Chairman and Vice-Chairman.
These officers shall perform the duties prescribed by these bylaws and the parliamentary
authority adopted by the Board of Health. The Health Director shall serve as secretary to the
Board of Health.
Section 2. At the regular meeting held in October, a Nominating Committee of three
members shall be appointed by the Chairman. It shall be the duty of this committee to
nominate candidates for the offices to be filled at the regular meeting held in December. The
Nominating Committee shall report at the regular meeting in November. Before the election
in December, additional nominations from the floor shall be permitted.
Section 3. The officers shall be elected by ballot to serve for one year or until their
successors are elected, and their term of office shall begin at the close of the regular meeting
at which they are elected.
Section 4. No member shall hold more than one office at a time, and no member shall
be eligible to serve more than two consecutive~terms in the same office.
I
Adopted, February 4, 1998p
2
128
II
I
ARTICLE V
Meetings
Section 1. The regular meetings of the Board of Health shall be held on the first
Wednesday of each month unless otherwise ordered by the Board of Health. All meetings
of the Board of Health are subject to the provisions of North Carolina's open meeting law.
Section 2. Special meetings may be called by the Chairman or by the Executive
Committee and shall be called upon written notice. The purpose of the meeting shall be
stated in the notice. Except in cases of emergency, at least three days' advanced notice shall
be given.
Section 3. All rules and regulations previously adopted by the Board of Health may
only be amended by a two-thirds vote of the entire membership.
Section 4. Six members of the Board of Health shall constitute a quorum.
ARTICLE VI
Executive Committee
Section 1. The officers of the Board of Health and three members appointed by the
Chairman shall constitute the Executive Committee. It has been the practice of the Board
of Health to include the Immediate Past-Chairman as one of the three appointed members.
I
Section 2. The Executive Committee shall have general supervision of the affairs of the
Board of Health between its regular meetings. The Executive Committee shall be subject
to the orders of the Board of Health and none of its acts shall conflict with action taken by
the Board of Health. Action taken by the Executive Committee shall be reported to the
Board of Health for ratification.
Section 3. The Chairman may call special meetings of the Executive Committee.
ARTICLE VII
Committeçs
Section 1. A Budget Committee shall be composed of all members of the Board of
Health. In December, the Chairman shall appoint its members to a Division of the New
Hanover County Health Department. It shall be the duty of this committee to assist in the
preparation ofthe budget for the fiscal year beginning the first day of July.
Section 2. An Environmental Health Committee composed of five members shall be
appointed by the Chairman in January. It shall be the duty of this committee to act as an
advisor to the Board of Health with respect to environmental health matters.
I
Section 3. A Health Promotion Committee composed of five members shall be
appointed by the Chairman in January. It shall be the duty of this committee to act as an
advisor to the Board of Health with respect to health promotion and disease prevention
matters.
Adopted, February 4, 1998
3
124
Section 4. An Animal Control Services Advisory Committee shall be composed of
members appointed by the Board of Health as set forth under Section 3-2 of the New
Hanover County Code. Members will include, but not be limited to, interested citizens, and
persons representing animal care, welfare or similar organizations. It shall be the duty of this
committee to act as an advisor to the Board of Health with respect to animal control matters.
Section 5. Such other committees, standing or special, shall be appointed by the
Chairman as the Board of Health or Executive Committee shall from time to time deem
necessary to carry on the work of the Board of Health. The Chairman shall be ex officio a
member of all committees except the Nominating Committee. The Chairman has no
obligation to participate at committee meetings and should not be counted in determining if
a quorum is present.
ARTICLE VIII
Parliamentary Authority
The rules contained in the current edition of Roberts Rules of Order Newly Revised shall
govern the Board of Health in all cases to which they are applicable and in which they are
not inconsistent with these bylaws and any special rules of order the Board of Health may
adopt.
ARTICLE IX
Amendment of Bylaws
These bylaws may be amended at any regular meeting of the Board of Health by a two-
thirds vote of the entire membership, provided that the amendment has been submitted in
writing at the previous regular meeting.
Dennis L. Jackson, D , Chairman
New Hanover Boara of Health
David E. Rice, MPH, MA, Health Director
New Hanover County Health Department
Adopted, February 4, 1998
I
I
;/)$p
I
4